State plans to boost Medicaid funding for contraception

Kirk McKoy/Los Angeles Times

Health care providers in Illinois would receive more money from Medicaid for providing vasectomies to men and birth control to women under proposed policy changes by the Department of Healthcare and Family Services.

Health care providers in Illinois would receive more money from Medicaid for providing vasectomies to men and birth control to women under proposed policy changes by the Department of Healthcare and Family Services. (Kirk McKoy/Los Angeles Times)

Wes Venteicher, Tribune reporter

Illinois says giving Medicaid patients better access to contraception will save money in the long run.

Medicaid patients in Illinois could gain increased access to contraception under policy changes proposed Wednesday by the Department of Healthcare and Family Services.

Health care providers would receive more money for providing vasectomies to men and birth control to women under the proposal, which also includes a possible new referral requirement for Roman Catholic providers and others that object to contraception.

The department expects to implement most of the proposed changes this fall, but department Director Julie Hamos said Medicaid will immediately start paying more toward the cost of long-term contraception at walk-in providers such as Planned Parenthood clinics.

Hamos said her department proposed the changes in part to address the recent Supreme Court decision that allowed some companies to exclude contraceptives from their employees' insurance coverage on religious grounds. Oklahoma-based arts-and-crafts retailer Hobby Lobby, owned by evangelical Christians, sued over a requirement under the Affordable Care Act to cover contraceptives.

The court's decision was of "extreme concern" to Gov. Pat Quinn and state health officials, Hamos said.

The new proposal affects residents covered under Medicaid, not by employers, but Hamos said the court's decision brought new focus to the issue, spurring the department to announce the proposal quickly.

"It is an opportune time when women across the country are paying attention … that's a time that we can really use that attention to focus on what's available to them through Medicaid," Hamos said. She noted that the change could help low-income women who shift between Medicaid and employer coverage as their employment situations change.

It's unbelievable that in 2014, the United States is still fighting about whether women should have access to birth control. Additionally, the costs of birth control is being effectively paid for by the employees

It's unbelievable that in 2014, the United States is still fighting about whether women should have access to birth control. Additionally, the costs of birth control is being effectively paid for by the employees

Unplanned pregnancies constitute a major cost among the approximately 1 million women of childbearing age enrolled in Medicaid in Illinois, Hamos said. About 3 million Illinoisans in all are enrolled, and the number is set to expand under the Affordable Care Act, commonly known as Obamacare.

Hamos said she could not provide cost estimates for the proposal but noted that 90 percent of Medicaid costs are being reimbursed by the federal government.

Expanded family planning has succeeded at saving money in other states, Hamos said, citing a Colorado initiative that she said cut teen birthrates by 40 percent from 2009 through 2013, reduced abortions and saved the state $42.5 million in 2010.

The Illinois proposal aims to coax more health care providers into expanding family planning services by increasing their reimbursement rates starting Oct. 1. Payments for vasectomies and intrauterine devices would be doubled. Hamos said the department is working with companies that manufacture IUDs to ensure they're on health care providers' shelves when needed.

The new policy also would increase reimbursement for nonsurgical sterilization kits, such as the device sold under the brand name Essure. Kai Tao, a senior policy adviser for the Department of Healthcare and Family Services, said the procedures are safer and less expensive than tubal ligation, the traditional surgical option, which Medicaid also covers.

In addition to the incentives, the proposal would prohibit "step therapy" rules that require a woman to try certain contraceptive methods before others. "It should be all about preventing and respecting the choice that she makes and how to do that," Hamos said.

The Illinois department is prevented under federal law from requiring a health care provider to give patients information on contraceptives if it claims a "right of conscience" objection. Officials are weighing whether the state has the legal authority to add a new requirement to refer interested patients to institutions that do offer the information, Hamos said.

Representatives of local Catholic hospitals and a Roman Catholic business owner who filed suit over the Affordable Care Act's contraception requirements did not immediately return phone calls.

The department, which worked with Planned Parenthood and other organizations on the proposal, is soliciting comments through Sept. 15 and expects to finalize the policy in the fall.

"This is a great way to give women access to the contraceptives they need in a timely fashion and have every contraceptive available to them," said Pam Sutherland, vice president for public policy and education for Planned Parenthood of Illinois.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.